Obamacare: What defines success?

The administration must convince the public that the law is more than a series of hiccups. | Reuters

“I think they need to find some way not to be so inflexible,” said Elaine Buccieri, a self-employed attorney in Arlington, Tex. She has always supported Obamacare, and says she still does — but can’t find an Obamacare plan that meets her needs without being significantly more expensive.

Buccieri is one of the lucky ones — she’ll get to keep her individual health plan into next year because Blue Cross Blue Shield of Texas has moved everyone’s “anniversary dates” to December 2014. But after that, she’ll probably have to switch to an Obamacare plan.

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And unlike other people in the same situation, Buccieri doesn’t have a bare-bones plan. She says it would be equivalent to a “silver” plan — the second-least-expensive kind of Obamacare coverage — and she can’t find one for a comparable price that would meet her prescription drug needs, which is her top priority.

To Buccieri, a recovery would mean giving people with individual plans more time to transition to Obamacare until insurers can offer better prices. “To have that pre-existing condition coverage is fantastic. I just think they need to get their pricing under control,” she said.

Even if Democrats did focus all their energy on the website, that assumes there will be a time when Obama can safely declare it fixed and not have to worry about being burned later. Administration officials have been deliberately vague about what would count as “fixed.” They generally stay close to the careful language Health and Human Services Secretary Kathleen Sebelius used this week, when she told the Finance Committee that the site should be “working smoothly for the vast majority of users” by the end of the month.

Joel Ario, the former head of the office in charge of Obamacare’s health insurance exchanges, said the administration will be able to declare the site back on track “if it works reasonably well for the vast majority of people — say, 85 or 90 percent.”

If that happens, Democratic strategists say, there’s still hope for a turnaround and the Democrats up for re-election will be fine — as long as the Obama administration does a better job carrying out the rest of the law.

“If the rest of the implementation is as dysfunctional as what we have seen, there certainly will be consequences,” said one Democratic campaign strategist. “But if the rest of the law is implemented the way it’s supposed to be, there won’t be political consequences.”

Political risks aside, the reality is that a functioning website is the key to achieving many other milestones of an Obamacare turnaround — like getting big enrollment numbers.

The administration is bracing for another tough political hit this week, when it releases the official early enrollment numbers. The White House has already been warning that the first month’s figures will be extremely low, but if the leaked numbers are correct, the federal website appears to have enrolled roughly as many people as the 14 states that are running their own health insurance exchanges.

But if the website is patched up enough to be useable, Obamacare could score bigger numbers later on, before the open enrollment season ends in March — especially with young adults, who are likely to sign up at the last minute.

Some health care experts say there’s no substitute for being patient — and waiting for more people to get coverage.

“The winners have to greatly outnumber the losers,” said Drew Altman of the Kaiser Family Foundation. “They win the fight if the vast majority of people like the coverage they’re getting.”

Democratic strategists say they’re still counting on the long game. Sure, Senate Democrats will go to the White House and hold Obama accountable on the sloppy implementation, they say, but that’s because it’s their job to do so. As long as Republicans keep talking about blocking the law, they says, Democrats can remind the public of the hugely unpopular shutdown and still have the upper hand in the 2014 elections.

And as the majority of Americans realize the law doesn’t even touch them, Democrats say, they’ll move on and the website problems will fade away.

“The main concern most people have is the uncertainty. It’s not the individual mandate. It’s not the exchanges. It’s not any particular part of the law. It’s the uncertainty,” said the Democratic campaign strategist. “Time is on the Democrats’ side. It’s not on the Republicans’ side.”

Jim Manley, a Democratic strategist and former Reid spokesman, says the Democrats “just have to grind it out, be as transparent as possible, give the public and the media the information they want, and keep it up until it’s working.”

And one more thing, Manley said: Don’t start calling for people’s heads. That could happen if the problems continue, as Pryor hinted in his statement after the White House meeting, when he said he told Obama to “hold the individuals in charge accountable for these mistakes.”

“The one thing I’m worried about is that they are going to start looking for scapegoats. That’s just going to make the sharks circle even more,” Manley said.